Dorien Bangma

18 | CHAPTER 1 Cognitive deficits, however, do not necessarily result in problems with (financial) decision- making due to a possible compensatory role of the affective/experiential processing of information. Both systems work simultaneously, are not superior to one another and might be situational dependent (Evans, 2008; Kahneman, 2003). Furthermore, contextual factors, as proposed in the conceptual model of Appelbaum et al. (2016), might be of influence such as age, gender, motivation or income. Contextual factors should, therefore, also been taken into account when studying FDM. Outline of the thesis The aim of the current thesis is to elaborate on currently available FDM research and to investigate if and how FDM can be measured more objectively in order to make (clinical) decisions about an individual’s capability to make financial decisions. For this, with the use of systematic review and meta-analytic methods, an overview of studies using performance-based tests to evaluate (financial) decision-making will be provided. Furthermore, several studies presented in the current thesis aim to systematically and comprehensively study the FDM capability of individuals with and without cognitive dysfunctions using multiple tests and questionnaires that assesses financial knowledge, financial judgment and financial performance. In addition, the influence of several contextual factors and cognition on FDM will be evaluated. For this purpose, several new FDM tests and questionnaires have been developed. In chapter 2 all (new) tests and questionnaires are introduced and information is provided about the administration and scoring of each test or questionnaire. Subsequently, in the second part of the thesis, the focus lies on FDM in relation to normal and abnormal aging. Normal aging is accompanied by changes in cognition, and a decline in cognitive functioning may negatively affect FDM capability of older individuals (Denburg & Hedgcock, 2015). On the other hand, more knowledge and experience may enhance the FDM performances of older adults compared to younger individuals (Hess, 2015; Peters et al., 2007). The study presented in chapter 3 evaluates the effects of normal aging on multiple aspects of FDM. Sometimes individuals, however, experience a degree of physical and cognitive problems not consistent with normal aging. Patients with neurodegenerative diseases (NDDs) experience more serious problems with cognition not associated with normal aging (American Psychiatric Association, 2013; Hardiman & Doherty, 2016). This makes these patients vulnerable for problems with FDM. In the review and meta-analyses presented in chapter 4 , a comprehensive overview of the literature is provided focusing on FDM in patients with different NDDs in comparison to healthy controls. Only studies using performance-based tests of FDM are included. Furthermore, if possible, patients with different NDDs are compared and the association between FDM and disease severity, cognition, age, sex and level of education are evaluated. In chapter 5 preliminary results are described of a study evaluating the performances of patients with Alzheimer’s disease (AD), mild cognitive impairment (MCI) and Parkinson’s disease (PD) in comparison to healthy controls on our FDM test battery. The third part of the thesis focuses on adults with attention-deficit/hyperactivity disorder (ADHD). ADHD is historically described as a childhood disorder, characterized by problems with attention, hyperactivity and impulsivity (American Psychiatric Association, 2013). Now-